AcuteCare Telemedicine Blog


Information in an Instant

There are countless factors that prevent patients from getting to see their doctors. Sometimes the simple fear of ‘getting sick’ and missing time at work or important commitments to our friends and family can stop us. Other times, distance, obligation, or extreme weather conditions can inhibit our ability to get to the hospital, even in cases of emergency. Whether the problem is voluntarily or logistically difficult, doctors and patients have long looked for solutions to these challenges to create a better standard of care.

Thankfully, the 21st century has afforded society some incredible opportunities to mitigate the barriers that stand between people and adequate healthcare services. Many disciplines of medicine are now mobile, capable of patient and doctor interaction regardless of the distance separating them. We have medical devices and software that can perform tasks such as automatically reading and uploading vital statistics for patient monitoring directly into an electronic health record. It has already been widely shown that reducing unnecessary hospital visits results in cost savings for the provider and the patient alike. Now, technologies such as those used in this type of monitoring is also enabling doctors to take better care of patients, helping them maintain an open line of communication, without being too invasive.

Between new monitoring techniques and the proliferation of location-based services, doctors can now effectively keep 24/7 tabs on at-risk patients, and might even be capable of sending the appropriate emergency response to victims of heart attack or stroke. It is mind-boggling to think that through powerful new devices and lightning-fast internet infrastructure, a doctor could actually know a stroke is progressing before the patient does.

With the prominent role we as a society assign to technology, it seems only fitting that it is now working to help save our lives. Physicians 50 years ago could hardly have envisioned these futuristic capabilities; it is an extremely exciting time to be practicing medicine on the cutting edge of technology.



Building Better Policy

Over the past several years, studies such as those conducted by the CDC and the National Institute of Health have constantly shown great disparity in levels of healthcare access across America. Particularly for poorer and rural areas, a lack of proper access has historically been extremely costly both in terms of human life and a greater economic impact. Policy makers, government officials, and leaders of health care organizations have recognized this divide, and are focused on identifying and eliminating barriers to patient access to provide a better, more uniform standard of effective healthcare across the country.

Thanks largely to leaps in technology and growing infrastructure, telemedicine is emerging as a highly effective solution with the potential to shape the future landscape of healthcare in America. The innovative, modern solutions offered by the growing telemedicine field combat the logistical challenges of the current state of healthcare, while having been proven to be more cost effective. Now, legislators are finally beginning to see the light.

On a state level, governments that have passed new telehealth legislation have seen positive results across the board. Powerful new applications and techniques have helped simplify and streamline remote patient consultation and monitoring, delivering better care with less economic impact with patient satisfaction rates nearing 100%. A dozen states, including Georgia, are leading the way on acknowledging telemedicine as an effective and efficient solution. So far in 2012, Maryland and Vermont have become the latest states to require private insurance companies to pay for telemedicine services.

The adoption of telemedicine marks a revolution in healthcare that carries great possibility for lasting impact. Creating a legislative environment in which telemedicine can flourish must continue to become a priority in a nation interested in reducing costs and saving lives.



ACT Discusses Teleneurology Outlook with Leading GA Stroke Professionals

Dr. Matthews Gwynn, Partner, AcuteCare Telemedicine (ACT) delivered a presentation discussing the future of teleneurology in the next decade during the quarterly meeting of the Georgia Stroke Professional Alliance (GSPA) on Wednesday, August 15th.

Dr. Gwynn’s presentation, visible online in its entirety here, was entitled “Beyond tPA: Teleneurology for This Decade.” Dr. Gwynn opened the presentation by discussing the prevalence of stroke, and covered a brief historical outline of the integration of telemedicine technologies in cutting edge neurological care. He then offered case studies demonstrating the value of teleneurology in creating a higher standard of stroke care in the future. Dr. Gwynn illustrated that teleneurology carries added benefits for not only improving care, but also serving to help healthcare providers meet changing standards and tightening budgets.

The audience was comprised of 60 of Georgia’s leading stroke professionals representing health care organizations across the state. The GSPA’s mission is to prevent stroke and optimize stroke care through professional networking and education. ACT is committed to promoting the availability and provision of specialized healthcare services in rural and underserved parts of Georgia through telemedicine technology.

“It is important to share and discuss with practitioners how the latest advancements in technology and technique can improve the prevention and treatment of stroke,” said Gwynn. “Presenting a positive outlook on the future of teleneurology to the GSPA was an outstanding opportunity to share our vision with other individuals who are leaders in our field. Hospitals, healthcare providers, and most important, Georgia citizens at risk for stroke benefit greatly from this exchange of knowledge.”

For more information about Dr. Gwynn and ACT, visit www.acutecaretelemed.com.

 



Botox – The Poison that Heals

Ounce for ounce, a molecule made by the bacterium Clostridium botulinum is the most potent neurotoxin on earth. A tiny amount ingested or introduced to the body through wounds has been enough to paralyze all the muscles in a human for more than long enough to allow suffocation from respiratory failure. The structure and biology of this large molecule, primarily made of protein, was deciphered just in the last century, but its ability to quickly and easily get into humans made it of great interest to scientists and physicians around the world.

Over time after its discovery, physicians came to understand that there could actually be medicinal qualities to this poison. One such interesting properties of botulinum toxin was its mechanism to weaken muscles by being taken up by the nerve endings attached to those muscles. This shuts down the nerve endings and their communication with muscles which keeps the muscles from contracting. When exposure is due to a bacterial infection, the toxin is widely distributed, coming into contact with nerves throughout the body, including those of the chest and diaphragm, resulting in breathing paralysis.

But what would happen if a tiny amount of the toxin was isolated and injected right at a site of a muscle in doses that were too small to have any effect elsewhere? Using a small dose would preclude weakness developing throughout the body and produce effects just locally. In fact, this is exactly what happened; an ophthalmologist who was a previously involved with the Army project injected eye muscles of children with crossed eyes (strabismus), weakening the muscles that were pulling too far and straightening out the gaze. The results were very good with few or no side effects.

Ultimately, many other indications came along, all based on the theory that relaxation of muscles can have a desired effect. By far the most publicized application of Botox in particular has been for the treatment of wrinkles – popularized as a fountain of youth in a bottle. Shortly after, it was discovered that patients with chronic headaches, including migraine, who received Botox for wrinkle treatment in the foreign were alleviated, incurring fewer headaches.

The mechanism of action regarding headaches is unknown. Some scientists suggest that the relief results from the interaction of Botox with sensory nerves as well as its known effect on motor nerves. There is evidence of this, but it remains a mystery how it works. Studies clearly show that it does not get into the brain or spinal cord and so does not affect pain centers there. The muscle relaxation itself probably doesn’t play a huge role, though there are sensory receptors within muscle fibers that may be influenced.

The story of this poison that heals is truly fascinating and represents one of the most important medical advances in the last two decades. The future could be even more interesting, as it may be possible to use the properties of some parts of the botulinum toxin to bring other molecules into nerves and have effects on them. This may have implications in trying to restore function and vitality to weakened nerves from many diseases. But for now, millions of people have found that Botox is at least worth a shot.

Read a more detailed history and perspective on Botox here.



An Instant Second Opinion

When citizens of a past age first envisioned practical telemedicine in 1924, the images and words on display at Worlds’ Fairs and in magazines likely seemed outlandish – a very optimistic and very distant look into the future. Few could have imagined that technology would make such great strides as to allow the development of a widely implemented network of functioning telemedicine programs less than a century later. Other futurists over the years have dreamed big, pushing forward medical innovation by imagining things like cure-all superdrugs and efficient and clean and precise surgery without a scalpel that are, believe it or not, now becoming reality as well.

As thought-provoking as these examples are, few of these big ideas are in actuality as practical or realistic as the avenues that have been opened for physician collaboration by advances in technology. Collaboration may be a lower impact medical advance than, say, leaps in prosthetics technology, but today, hospital leaders and physicians work considerably more interdependently to improve clinical outcomes and simultaneously combat healthcare logistical challenges and expenses. Increased capacity for collaboration is a major improvement enabled by powerful new telecommunication technologies that allow live consultation between physicians, regardless of distance, and unites the many individuals involved in any one patient’s care.

Telemedicine programs have helped hospital administrators create a better practice environment that results in improved recruiting and retention and fosters a virtuous cycle of better patient care and financial outcomes. One of the greatest advances simply by facilitating two-way conversation for professionals who are used to talking at each other instead of with each other. Collaboration is, in reality, the most tangible of telemedicine’s many benefits.